〔大〕夫妊娠忽然心腹刺痛,闷绝欲死者,谓之中恶。邪恶之气中胎,伤于人也。所
以然者,血气自养而为精神之主。若血气不和,则精神衰弱,故邪毒之气得以中之,妊
娠之病,亦致损胎也。
〔薛〕前证当调补正气为善,用金银藤一味煎汤饮之。
当归散 治妊娠中恶,心腹 痛。
当归 丁香 川芎(各三两) 青橘皮(二两) 吴茱萸(半两,去梗汤泡三次,炒黑)
上为细末,无时,温酒调一钱。
又方 生干地黄(一两) 枳壳 木香(各七钱半) 为细末,每服一钱,酒调下。
又方 苦梗(二两,细锉略炒) 生姜(半两) 水煎服之。
《补遗》治妊娠中恶,心腹绞急切痛,如鬼击之状,不可按摩,或吐血,或衄血者,用
熟艾(如拳大。)煮汁频服。
又方 用盐一盏,水二盏,调和服,以冷水 之,吐出即安。
又方 灶心土为末,每二钱,井水调服,白汤调亦可。
又法 取汗衣,用男子贴体久染汗者佳。烧灰存性,百沸汤调服。
〔大〕论曰∶夫四时八方之气为风也,常以冬至之日候之,若从其乡来者,长养万
物。若不从其乡来者,名为虚邪,贼害万物,人体虚则中之。若风邪客于皮肤,入于经络,
即顽痹不仁。若入于筋脉,挟寒则挛急 僻,挟温客弛纵。若入脏腑,则恍惚惊悸。凡五
脏俞皆在背,脏腑虚寒,邪皆从俞而入,随所伤脏腑经络而为诸病,妊娠中风,若不早
治,则令堕胎也。
〔薛〕按《病机机要》云∶风本为热,热胜则风动,宜以静胜其躁,是亦养血也。治
法须少汗,亦宜少下,多汗则虚其卫,多下则损其荣,虽有汗下之戒,而有中脏、中腑
之分。中腑者多着四肢,则脉浮恶寒,拘急不仁。中脏者多着九窍,则唇缓失音,耳聋
鼻塞,目瞀便秘。中腑者宜汗之,中脏者宜下之,表里已和,宜治在经,当以大药养之,
此中风要法。妊妇患之,亦当以此施治,而佐以安胎之药。
防风散 治妊娠中风卒倒,心神闷乱,口噤不能言,四肢急强。
防风(去芦) 葛根 桑寄生(各一两) 羚羊角屑 细辛(去苗) 当归(去芦)
甘菊花 汉防己(去皮) 秦艽(去芦) 桂心 茯神(去木) 甘草(炙,各半两)
上为 咀,每服八钱,水一中盏半,生姜五片,煎至一大盏,去滓入竹沥半合,搅
匀,温服无时。
生犀角散 治妊娠卒中风不语,四肢强直,心神 愦。
牛犀角屑 麻黄(去节,各一两) 防风(去芦) 赤箭 羌活 当归 人参(各去芦)
葛根 赤芍药(各七钱半) 甘草(炙) 秦艽(各半两) 石膏(一两半)
上为 咀,每服八钱,煎服法如前。
防己散 治妊娠中风,口眼 斜,手足顽痹。
防己(去皮) 羌活 防风(各去芦) 麻黄(去节) 黄松木节 羚羊角(屑,各一两)
桂心 荆芥穗 薏苡仁 桑寄生 甘草(炙,各半两)
上 咀,每服五钱,水一中盏半,生姜五片,煎至一大盏,去滓温服,不拘时候。
独活散 治妊娠因洗头中风,身体强硬,牙关紧急,失音不语,并皆治之。
独活(去芦) 赤箭 麻黄(去节) 阿胶(各一两,炒) 乌犀角屑 羌活(去芦) 防风(去芦)
天蓼木 白附子(炮,各七钱半) 汉防己(去皮) 桂心 芎 白僵蚕(微炒,各半两)
龙脑(二钱半,细研)
上为细末,入研药令匀,每服二钱,薄荷汤调下,不拘时。
白僵蚕散 治妊娠中风口噤,心膈痰涎壅滞,言语不得,四肢强直。
白僵蚕(炒) 天麻 独活(去芦,各一两) 麻黄(去节,一两半) 乌犀角屑(七钱半)
白附子(炮) 半夏(汤洗七次,姜制) 天南星(炮) 藿香(各半两) 龙脑(二钱半,研)
上为细末,入研药令匀,每服一钱,生姜、薄荷汤调下,不拘时日,三服。
赤箭丸 治妊娠中风,手足不随,筋脉缓急,言语謇涩,皮肤不仁。
赤箭 萆 (酒浸) 麻黄(去节) 独活(去芦) 鼠粘子 熟干地黄 羚羊角(屑,各一两)
阿胶(炒) 防风(去芦) 芎 当归(炒,去芦) 薏苡仁 五加皮 秦艽(去芦) 汉防己(去皮)
柏子仁 酸枣仁(炒) 丹参(去芦,各七钱半)
上为细末,炼蜜和捣三五百下,丸如梧子大。每服三十丸,豆淋酒送下,食前。
白术酒 治妊娠中风口噤,语言不得。
白术(一两半) 独活(一两) 黑豆(一合,炒)
上细锉,以酒三升,煎取一升半,去滓温,分四服。口噤者拗口灌之,得汗即愈。
治妊娠因感外风如中风状,不省人事。
熟艾(三两) 陈米醋炒令极热,以绢帛裹熨脐下,良久即省。
【大论】孕妇忽然出现心腹剧烈刺痛,胸闷气短甚至昏厥欲死的情况,称为“中恶”。这是邪恶之气侵袭胎元,伤害人体的缘故。之所以会这样,是因为气血本应滋养身体并作为精神的主宰。如果气血不和,就会导致精神衰弱,因此邪毒之气得以乘虚而入。妊娠期间的这种病症,也会损伤胎儿。
【薛己】上述症状应当以调补正气为善策,可以使用金银藤一味药煎汤饮用。
当归散:治疗妊娠中恶,心腹疼痛。
配方:当归、丁香、川芎(各三两)、青橘皮(二两)、吴茱萸(半两,去除梗茎后用热水浸泡三次,炒至黑色)。
制法与用法:将上述药物研成细末,随时可用温酒调服一钱。
又一方:生干地黄(一两)、枳壳、木香(各七钱半)。
制法与用法:研成细末,每次服用一钱,用酒调服。
又一方:苦梗(二两,细细切碎略炒)、生姜(半两)。
制法与用法:加水煎煮后服用。
《补遗》记载:治疗妊娠中恶,心腹绞痛急切,如同被鬼击打一般,不可按摩,或者吐血、鼻出血者,使用熟艾(如拳头大小),煮汁频繁服用。
又一方:取盐一盏,水二盏,调和后服用,并用冷水喷洒其身,吐出后即安适。
又一方:灶心土研成粉末,每次服用二钱,用井水调服,用白开水调服也可以。
又一种方法:取贴身穿着已久的汗衣,以男子贴体久染汗水者为佳。烧成灰但保留药性,用滚开的汤水调服。
【大论】论述说:四季八方之气形成风,通常在冬至日观察风向,如果风从其所来的方向(即当令之乡)吹来,则能长养万物。如果不从其所来的方向吹来,就称为“虚邪”,会贼害万物,人体虚弱时就会受到侵袭。如果风邪客居于皮肤,进入经络,就会导致肢体麻木不仁。如果进入筋脉,挟带寒气则会导致拘挛抽搐或口眼歪斜,挟带温热之气则导致弛缓无力。如果进入脏腑,则会导致神志恍惚、惊悸。凡是五脏的俞穴都在背部,如果脏腑虚寒,邪气都从俞穴侵入,随着所伤害的脏腑经络而引发各种疾病。妊娠期间中风,如果不及时治疗,就会导致堕胎。
【薛己】按《病机机要》所说:风本质属热,热盛则风动,应当以静制动,这也是养血的方法。治疗方法应当适度发汗,也应当适度通便,发汗过多则会耗伤卫气,泻下过多则会损伤营血。虽然有发汗和泻下的禁忌,但有中脏和中腑的区别。中腑的病证多表现在四肢,脉象浮且恶寒,肢体拘急不仁。中脏的病证多影响九窍,表现为口唇松弛失音、耳聋鼻塞、视物模糊、便秘。中腑适宜发汗,中脏适宜泻下。表里调和之后,适宜调理经脉,应当用大药滋养身体,这是治疗中风的关键法则。孕妇患此病,也应当以此法施治,并辅助以安胎的药物。
防风散:治疗妊娠中风突然昏倒,心神烦闷混乱,牙关紧闭不能说话,四肢僵硬强直。
配方:防风(去芦头)、葛根、桑寄生(各一两)、羚羊角屑、细辛(去苗)、当归(去芦)、甘菊花、汉防己(去皮)、秦艽(去芦)、桂心、茯神(去木质部)、甘草(炙,各半两)。
制法与用法:将药物捣碎成粗颗粒,每次服用八钱,用水一中盏半,生姜五片,煎至一大盏,滤去药渣,加入竹沥半合,搅拌均匀,随时温服。
生犀角散:治疗妊娠突然中风不语,四肢强直,心神烦乱昏沉。
配方:牛犀角屑、麻黄(去节,各一两)、防风(去芦)、赤箭(天麻)、羌活、当归、人参(各去芦头)、葛根、赤芍药(各七钱半)、甘草(炙)、秦艽(各半两)、石膏(一两半)。
制法与用法:将药物捣碎成粗颗粒,每次服用八钱,煎服方法同上。
防己散:治疗妊娠中风,口眼歪斜,手足麻木不仁。
配方:防己(去皮)、羌活、防风(各去芦头)、麻黄(去节)、黄松木节、羚羊角(屑,各一两)、桂心、荆芥穗、薏苡仁、桑寄生、甘草(炙,各半两)。
制法与用法:将药物捣碎成粗颗粒,每次服用五钱,用水一中盏半,生姜五片,煎至一大盏,滤去药渣温服,不拘时间。
独活散:治疗妊娠因洗头受风,身体强硬,牙关紧急,失音不语,均能治疗。
配方:独活(去芦头)、赤箭、麻黄(去节)、阿胶(各一两,炒)、乌犀角屑、羌活(去芦头)、防风(去芦头)、天蓼木、白附子(炮制,各七钱半)、汉防己(去皮)、桂心、川芎、白僵蚕(微炒,各半两)、龙脑(二钱半,细研)。
制法与用法:将药物研成细末,加入已研好的药物混合均匀,每次服用二钱,用薄荷汤调服,不拘时间。
白僵蚕散:治疗妊娠中风口噤,心膈痰涎壅滞,言语不能,四肢强直。
配方:白僵蚕(炒)、天麻、独活(去芦头,各一两)、麻黄(去节,一两半)、乌犀角屑(七钱半)、白附子(炮制)、半夏(热水洗七次,姜制)、天南星(炮制)、藿香(各半两)、龙脑(二钱半,研)。
制法与用法:将药物研成细末,加入已研好的药物混合均匀,每次服用一钱,用生姜、薄荷汤调服,不拘时日,服用三次。
赤箭丸:治疗妊娠中风,手足不能随意活动,筋脉或缓或急,言语謇涩,皮肤麻木不仁。
配方:赤箭、萆薢(酒浸)、麻黄(去节)、独活(去芦头)、鼠粘子(牛蒡子)、熟干地黄、羚羊角(屑,各一两)、阿胶(炒)、防风(去芦头)、川芎、当归(炒,去芦头)、薏苡仁、五加皮、秦艽(去芦头)、汉防己(去皮)、柏子仁、酸枣仁(炒)、丹参(去芦头,各七钱半)。
制法与用法:将药物研成细末,用炼蜜调和并捣杵三五百下,制成梧桐子大小的丸剂。每次服用三十丸,用豆淋酒送下,饭前服用。
白术酒:治疗妊娠中风口噤,语言不能。
配方:白术(一两半)、独活(一两)、黑豆(一合,炒)。
制法与用法:将药物细细切碎,用酒三升,煎取一升半,滤去药渣温服,分四次服用。对于口噤不能张口者,撬开嘴巴灌服,出汗后即可痊愈。
治疗妊娠因感受外风类似中风症状,不省人事。
配方:熟艾(三两)。
制法与用法:用陈米醋炒至极热,用绢帛包裹熨烫脐下部位,许久后即可苏醒。
[Da] If a pregnant woman suddenly experiences severe stabbing pain in the heart and abdomen, accompanied by chest oppression, syncope, or a sensation of impending death, this is termed "Zhong E" (Sudden Evil Invasion). This occurs when evil qi invades the fetus and harms the body. The reason for this is that blood and qi should nourish the body and serve as the master of spirit. If blood and qi are disharmonious, spirit becomes weak, allowing toxic evil qi to invade. Such diseases during pregnancy can also damage the fetus.
[Xue] For the aforementioned symptoms, it is advisable to regulate and tonify righteous qi. One may decoct and drink a single herb: Lonicerae Japonicae Caulis (Jinyinhua Teng, 金银藤).
Danggui San (Angelica Powder): Treats Zhong E during pregnancy with heart and abdominal pain.
Ingredients: Radix Angelicae Sinensis (Danggui), Fructus Tsaoko (Dingxiang), Radix Chuanxiong (Chuanxiong) (each 3 liang), Pericarpium Citri Reticulatae Viride (Qingjupi), Fructus Evodiae (Wuzhuyu) (0.5 liang, remove stems, soak in hot water three times, stir-fry until black).
Preparation and Administration: Grind into fine powder. At any time, mix one qian with warm wine and take orally.
Another prescription: Radix Rehmanniae Preparata (Sheng Shengdihuang), Fructus Aurantii (Zhiqiao), Radix Aucklandiae (Muxiang) (each 7.5 qian).
Preparation and Administration: Grind into fine powder. Take one qian each time, mixed with wine.
Another prescription: Radix Platycodonis (Kujie) (2 liang, finely cut and slightly stir-fried), Rhizoma Zingiberis Recens (Shengjiang) (0.5 liang).
Preparation and Administration: Decoct in water and take.
"Buiyi" records: To treat Zhong E during pregnancy with severe, cramping heart and abdominal pain, resembling a ghost strike, where massage is contraindicated, or accompanied by hematemesis or epistaxis, use Folium Artemisiae Argyi (Shuai Ai) (size of a fist), decoct in water, and take frequently.
Another prescription: Mix one chalice of salt with two chalices of water, take orally, and spray cold water on the body. Relief follows vomiting.
Another prescription: Use Caosin Tu (Zaoxin Earth) ground into powder. Take two qian each time, mixed with well water; white boiled water may also be used.
Another method: Take an old sweat-stained undergarment worn closely by a man. Burn to ash but retain its medicinal nature. Mix with boiling water and take.
[Da] Discussion states: The winds from the eight directions across the four seasons constitute wind. One should observe the wind direction on the day of Winter Solstice. If the wind comes from its proper direction (its native region), it nurtures all things. If it does not come from its proper direction, it is called "Xu Xie" (Empty/False Evil), which harms all things; the human body, when deficient, is susceptible to invasion. If wind pathogen lodges in the skin and enters the meridians, it causes numbness and loss of sensation. If it enters the sinews and vessels, accompanying cold leads to spasms or deviation; accompanying warmth leads to flaccidity. If it enters the zang-fu organs, it causes mental confusion and palpitations. All five zang-shu points are located on the back. If the zang-fu are deficient and cold, pathogens enter via these shu points and cause various diseases according to the affected organs and meridians. Stroke during pregnancy, if not treated early, can lead to miscarriage.
[Xue] According to "Bingji Jingyao": Wind is essentially heat; when heat prevails, wind moves. One should use stillness to overcome agitation, which is also a method of nourishing blood. Treatment methods require moderate sweating and moderate purgation. Excessive sweating damages Wei Qi (Defensive Qi); excessive purgation damages Ying Blood (Nutritive Blood). Although there are taboos against sweating and purging, there is a distinction between stroke affecting the zang organs versus the fu organs. Stroke affecting the fu organs often manifests in the four limbs, with floating pulse and aversion to cold, stiffness, and numbness. Stroke affecting the zang organs often affects the nine orifices, presenting with flaccid lips and aphonia, deafness, nasal congestion, blurred vision, and constipation. Fu organ stroke is suitable for diaphoresis; zang organ stroke is suitable for purgation. Once the exterior and interior are harmonized, treatment should focus on the meridians, using major tonics to nourish the body. This is the essential method for treating stroke. Pregnant women suffering from this should be treated accordingly, assisted by fetal-calming herbs.
Fangfeng San (Saposhnikovia Powder): Treats sudden collapse due to stroke during pregnancy, mental restlessness, locked jaw unable to speak, and stiff, rigid limbs.
Ingredients: Radix Saposhnikoviae (Fangfeng, remove rhizome), Radix Puerariae (Gegen), Ramulus Taxilli (Sangjisheng) (each 1 liang), Cornu Saigae Tataricae (Lingyangjiao xie), Radix Asari (Xixin, remove seedlings), Radix Angelicae Sinensis (Danggui, remove rhizome), Flos Chrysanthemi Indici (Gan Juhua), Radix Stephaniae Tetrandrae (Han Fangji, remove bark), Radix Gentianae Macrophyllae (Qinjiao, remove rhizome), Cortex Cinnamomi (Guixin), Radix Polygalae (Fushen, remove wood), Radix Glycyrrhizae (Gancao, honey-fried) (each 0.5 liang).
Preparation and Administration: Coarsely crush the herbs. Take 8 qian each time, with 1.5 chalices of water and 5 slices of fresh ginger. Decoct to 1 chalice, strain, add 0.5 he of Bamboo Juice (Zhuli), mix well, and take warm at any time.
Sheng Xijiao San (Fresh Rhinoceros Horn Powder): Treats sudden aphonia due to stroke during pregnancy, rigid limbs, and mental confusion.
Ingredients: Cornu Bubali (Niuxijiao xie), Radix Ephedrae (Mahuang, remove joints) (each 1 liang), Radix Saposhnikoviae (Fangfeng, remove rhizome), Rhizoma Gastrodiae (Chijian/Tianma), Radix Notopterygii (Qianghuo), Radix Angelicae Sinensis (Danggui), Radix Ginseng (Renshen) (remove rhizomes), Radix Puerariae (Gegen), Radix Paeoniae Rubra (Chishaoyao) (each 7.5 qian), Radix Glycyrrhizae (Gancao, honey-fried), Radix Gentianae Macrophyllae (Qinjiao) (each 0.5 liang), Gypsum Fibrosum (Shigao) (1.5 liang).
Preparation and Administration: Coarsely crush the herbs. Take 8 qian each time. Decoct and administer as above.
Fangji San (Stephania Powder): Treats stroke during pregnancy with facial paralysis (mouth and eye deviation) and numbness of hands and feet.
Ingredients: Radix Stephaniae Tetrandrae (Fangji, remove bark), Radix Notopterygii (Qianghuo), Radix Saposhnikoviae (Fangfeng) (remove rhizomes), Radix Ephedrae (Mahuang, remove joints), Lignum Pinus Massoniana (Huangsongmu jie), Cornu Saigae Tataricae (Lingyangjiao xie) (each 1 liang), Cortex Cinnamomi (Guixin), Herba Schizonepetae (Jingsheisui), Semen Coicis (Yiyiren), Ramulus Taxilli (Sangjisheng), Radix Glycyrrhizae (Gancao, honey-fried) (each 0.5 liang).
Preparation and Administration: Coarsely crush the herbs. Take 5 qian each time, with 1.5 chalices of water and 5 slices of fresh ginger. Decoct to 1 chalice, strain, and take warm. No specific timing required.
Duhuo San (Angelica Pubescens Powder): Treats stroke contracted while washing hair, causing body rigidity, locked jaw, aphonia, etc.
Ingredients: Radix Angelicae Pubescentis (Duhuo, remove rhizome), Rhizoma Gastrodiae (Chijian), Radix Ephedrae (Mahuang, remove joints), Colla Corii Asini (Ejiao) (each 1 liang, stir-fried), Cornu Bubali (Wuxijiao xie), Radix Notopterygii (Qianghuo, remove rhizome), Radix Saposhnikoviae (Fangfeng, remove rhizome), Radix Polygoni Multiflori? (Tiaoluomu - *Note: Text says Tianliaomu*), Rhizoma Typhonii (Baifuzi, processed) (each 7.5 qian), Radix Stephaniae Tetrandrae (Han Fangji, remove bark), Cortex Cinnamomi (Guixin), Radix Chuanxiong (Xiong), Bombyx Batryticatus (Bai Jiangcan, lightly stir-fried) (each 0.5 liang), Borneolum Syntheticum (Longnao) (2.5 qian, finely ground).
Preparation and Administration: Grind into fine powder, mix thoroughly with the ground ingredients. Take 2 qian each time, mixed with Mint Decoction. No specific timing required.
Bai Jiangcan San (Bombyx Powder): Treats locked jaw due to stroke during pregnancy, phlegm-fluid retention in heart and diaphragm, inability to speak, and limb rigidity.
Ingredients: Bombyx Batryticatus (Bai Jiangcan, stir-fried), Rhizoma Gastrodiae (Tianma), Radix Angelicae Pubescentis (Duhuo, remove rhizome) (each 1 liang), Radix Ephedrae (Mahuang, remove joints) (1.5 liang), Cornu Bubali (Wuxijiao xie) (7.5 qian), Rhizoma Typhonii (Baifuzi, processed), Rhizoma Pinelliae (Banxia, washed seven times in hot water, prepared with ginger), Rhizoma Arisaematis (Tian Nanxing, processed), Herba Agastaches (Huoxiang) (each 0.5 liang), Borneolum Syntheticum (Longnao) (2.5 qian, ground).
Preparation and Administration: Grind into fine powder, mix thoroughly with ground ingredients. Take 1 qian each time, mixed with Ginger and Mint Decoction. No specific timing required. Administer three doses.
Chijian Wan (Rhizoma Gastrodiae Pill): Treats stroke during pregnancy with involuntary limb movement, fluctuating tendon tension, slurred speech, and skin numbness.
Ingredients: Rhizoma Gastrodiae (Chijian), Rhizoma Dioscoreae Hypoglaucae (Bixie, soaked in wine), Radix Ephedrae (Mahuang, remove joints), Radix Angelicae Pubescentis (Duhuo, remove rhizome), Semen Arctii (Shuniuzi), Radix Rehmanniae Preparata (Shu Dihuang), Cornu Saigae Tataricae (Lingyangjiao xie) (each 1 liang), Colla Corii Asini (Ejiao, stir-fried), Radix Saposhnikoviae (Fangfeng, remove rhizome), Radix Chuanxiong (Xiong), Radix Angelicae Sinensis (Danggui, stir-fried, remove rhizome), Semen Coicis (Yiyiren), Cortex Acanthopanacis Senticosi (Wujia Pi), Radix Gentianae Macrophyllae (Qinjiao, remove rhizome), Radix Stephaniae Tetrandrae (Han Fangji, remove bark), Semen Plagiospermi (Baizi Ren), Semen Ziziphi Spinosae (Suanzaoren, stir-fried), Radix Salviae Miltiorrhizae (Danshen, remove rhizome) (each 7.5 qian).
Preparation and Administration: Grind into fine powder. Mix with refined honey and pound 300-500 times. Form pills the size of mulberry seeds. Take 30 pills each time before meals, delivered with Dou Lin Jiu (Bean-leavened Wine).
Baizhu Jiu (Atractylodes Wine): Treats locked jaw and aphonia due to stroke during pregnancy.
Ingredients: Rhizoma Atractylodis Macrocephalae (Baizhu) (1.5 liang), Radix Angelicae Pubescentis (Duhuo) (1 liang), Semen Sojae Nigrum (Heidou, 1 he, stir-fried).
Preparation and Administration: Finely cut the herbs. Decoct in 3 sheng of wine to obtain 1.5 sheng. Strain and take warm, divided into four doses. For locked jaw, pry open the mouth and pour in. Recovery follows sweating.
To treat pregnancy complicated by external wind resembling stroke, with loss of consciousness:
Ingredients: Folium Artemisiae Argyi (Shuai Ai) (3 liang).
Preparation and Administration: Stir-fry with aged rice vinegar until extremely hot. Wrap in silk cloth and apply as a hot compress to the lower abdomen. Consciousness returns after some time.